Original Article Increased Pulmonary Arterial Stiffness and Impaired Right Ventricle-Pulmonary Artery Coupling In PCOS
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Original Article
Increased Pulmonary Arterial Stiffness and Impaired Right Ventricle-
Pulmonary Artery Coupling In PCOS
Ozge Ozcan Abacioglu,1 Erdinc Gulumsek,2 Hilmi Erdem Sumbul,2 Mehmet Kaplan,1 Fethi Yavuz1
Health Sciences University, Adana Research and Training Hospital, Department of Cardiology, Adana - Turkey
1
Health Sciences University, Adana Research and Training Hospital, Department of Internal Medicine,2 Adana - Turkey
Abstract
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disease in women in reproductive
age, and occurs in one of 10 women. The disease includes menstrual irregularity and excess of male hormones and is the
most common cause of female infertility. Dyspnea is a frequent symptom and is often thought to be due to obesity, and
whether it is due to cardiac dysfunction is unknown.
Objective: To evaluate right ventricle-pulmonary artery (RV-PA) coupling and pulmonary arterial stiffness in patients
with PCOS.
Methods: 44 PCOS patients and 60 controls were included; venous blood samples were taken for laboratory tests and
2-D, m-mode and tissue doppler transthoracic echocardiography were performed for all the participants. PAbacioglu et al.
Right ventricle in PCOS
Original Article
Research Hospital between March 2019 and September The relationship between RV contractility and
2019. Data on demographic characteristics, medical history RV afterload is often referred to as RV-PA coupling .
and medication use were obtained and patients with Contractility refers to load independent or intrinsic
coronary artery disease, hypertension, diabetes mellitus, cardiac function, while afterload refers to the opposition
valvular heart disease rather than mild diastolic dysfunction, to ventricular ejection. RV- PA coupling was calculated
diagnosis or clinical findings (snoring, excessive daytime according to the following formula: TAPSE / SPAP and
sleepiness or witnessed apnea) of obstructive sleep apnea when a ratioAbacioglu et al.
Right ventricle in PCOS
Original Article
Table 1 – Baseline demographic features and laboratory parameters of groups, and statistical analysis
PCOS group n=44 Control group n=60
p-value
(mean ± SD) (mean ± SD)
Age, years 22 ± 5 24 ± 5 0.210
BMI, kg/ m2 24.86 ± 2.74 24.26 ± 2.25 0.329
Glucose (mg/ dL) 96.45 ± 12.52 90.16 ± 1.48 0.279
Urea (mg / dL ) 20.22 ± 5.53 23.38 ± 3.96 0.233
Sodium (mmol / L) 139.25 ± 1.72 137.60 ± 0.52 0.114
Potassium (mmol /L) 4.43 ± 0.29 4.33 ± 0.14 0.568
Calcium (mg / dL) 9.75 ± 0.35 9.62 ± 0.60 0.473
AST (u /L) 20.72 ± 5.06 19.88 ± 5.45 0.735
ALT (u /L) 16.90 ± 9.10 13.02 ± 2.01 0.354
LDL (mg /dL) 119.25 ± 22.81 111.16 ± 32.26 0.580
HDL (mg dL) 46.13 ± 13.28 42.30 ± 15.46 0.317
Triglycerides (mg /dL) 106.30 ± 78.40 91.66 ± 50.63 0.757
WBC (10 /µL)
3
7.60 ± 1.76 8.44 ± 2.79 0.318
HGB (g /dL) 12.90 ± 0.81 11.85 ± 2.10 0.238
PLT (10 /µL)
3
277.90 ± 69.23 272.85 ± 33.25 0.853
HOMA-IR 3.12 ± 2.00 2.16 ± .52 0.023
BMI: body mass index; AST: aspartate transaminase, ALT: alanine transaminase, LDL: low-density lipoprotein, HDL: high-density lipoprotein, WBC: white
blood count, HGB: hemoglobin, PLT: platelets, HOMA-IR: homeostatic model for insulin resistance.
and pulmonary acceleration time was shortened in the provide new clues in the treatment of PCOS and related
study group and the difference was statistically significant complications.11
(pAbacioglu et al.
Right ventricle in PCOS
Original Article
Table 2 – Left and right ventricular echocardiography characteristics of the study and control groups, and statistical analysis
PCOS group n=44 (mean ± SD) Control group n=60 (mean ± SD) p-value
LVEF (%) 61.45 ± 5.76 61.00 ± 5.32 0.810
IVS (mm) 8.85 ± 1.07 8.98 ± 1.24 0.633
PW (mm) 8.34 ± 1.06 8.63 ± 1.47 0.329
E/E’ 10.33 ± 1.57 10.39 ± 1.76 0.896
Tricuspid E velocity (cm/s) 80.25 ± 12.73 75.81 ± 12.20 0.140
Tricuspid A velocity (cm/s) 56.05 ± 8.33 56.25 ± 9.76 0.924
SPAP (mmHg) 19.04 ± 2.54 18.04 ± 1.74 0.064
AT (ms) 159.35 ± 24.08 179.17 ± 22.36 0.001
Maximum Pulmonary Velocity 87.38 ± 12.49 84.79 ± 6.21 0.299
TAPSE (cm) 2.18 ± 0.30 2.58 ± 0.25Abacioglu et al.
Right ventricle in PCOS
Original Article
Conclusion Potential Conflict of Interest
In summary, this study is the first to provide preliminary No potential conflict of interest relevant to this article
data that PCOS patients have increased pulmonary artery was reported.
stiffness and impaired RV-PA coupling.
Sources of Funding
Author contributions There were no external funding sources for this study.
Conception and design of the research, Analysis and
interpretation of the data, Statistical analysis, Obtaining financing,
Writing of the manuscript and Critical revision of the manuscript Study Association
for intellectual content: Abacioglu OO; Acquisition of data: This study is not associated with any thesis or dissertation
Abacioglu OO, Gulumsek E, Sumbul H, Kaplan M, Yavuz F. work.
Erratum
In Original Article “Increased Pulmonary Arterial Stiffness and Impaired Right Ventricle-Pulmonary Artery
Coupling In PCOS”, with DOI number: https://doi.org/10.36660/abc.20190762, published in the Journal
Arquivos Brasileiros de Cardiologia, 116(4):806-811, on page 806, corrigir o nome do autor Hilmi Sumbul
para: Hilmi Erdem Sumbul.
References
1. Ding T, Hardiman PJ., Petersen I, Wang FF , Qu F, and Baio G. The 11. Wilde MA, Eising JB, Gunning MN, Koster MPH, Evelein AMV, Dalmeijer
prevalence of polycystic ovary syndrome in reproductiveaged GW, et al. Cardiovascular and Metabolic Health of 74 Children From
women of different ethnicity: a systematic review and meta-analysis. Women Previously Diagnosed With Polycystic Ovary Syndromein
Oncotarget.2017;8(56):96351-8. Comparison With a Population-Based Reference Cohort. Reprod Sci. 2018
Oct;25(10):1492-500.
2. Baldani DP, Skrgatic L, Ougouage R.Polycystic Ovary Syndrome: Important
Underrecognised Cardiometabolic Risk Factor in Reproductive-Age 12. http://www.istanbulsaglik.gov.tr/w/tez/pdf/kardiyoloji/dr_dilek_ergun.pdf
Women. Int J Endocrinol.2015. doi.org/10.1155/2015/786362
13. Kosmala W, O’Moore-Sullivan TM, Plaksej R, Kuliczkowska-Plaksej J, Przewlocka-
3. Barats SS, Benedictov II, Shadrin SA. Cardiovascular disorders, autonomic Kosmala M, et al. Subclinical impairment of left ventricular function in young
disorders and atherogenic dyslipoproteinemias in young women with the obese women: contributions of polycystic ovary disease and insulin resistance. J
sclerotic ovary syndrome. Kardiologiia. 1984 Aug;24(8):34-7. Clin Endocrinol Metab. 2008 Oct;93(10):3748-54
4. Wang ET, Ku IA, Shah SJ. et al. Polycystic Ovary Syndrome Is Associated with 14. Simakova MA, Ryzhkov AV, Kyzymly AV, Naimushin AV, Lukinov VL,
Higher Left Ventricular Mass Index: The CARDIA Women’s Study J Clin Moiseeva ОМ. Perspectives of using pulmonary arterial stiffness indicators
Endocrinol Metab. 2012 Dec; 97(12): 4656–62. to evaluate the prognosis of patients with pulmonary arterial hypertension.
Ter Arkh.2018 Feb 14;90(1):86-92
5. Gupta A, Sharifov OF, Lloyd SG, Tallaj JA, Aban I, Dell’italia LJ, et al. Novel
Noninvasive Assessment of Pulmonary Arterial Stiffness Using Velocity 15. Hsu S. Coupling Right Ventricular-Pulmonary Arterial Research to
Transfer Function. J Am Heart Assoc. 2018 Sep 18;7(18):e009459 the Pulmonary Hypertension Patient Bedside. Circ Heart Fail. 2019
Jan;12(1):e005715
6. Friesen RM, Schäfer M, Ivy DD, Abman SH, Stenmark K, Browne LP, et al.
Proximal pulmonary vascular stiffness as a prognostic factor in children with 16. Sun W, Chan SY. Pulmonary Arterial Stiffness: An Early and Pervasive
pulmonary arterial hypertension. Eur Heart J Cardiovasc Imaging. 2019 Feb Driver of Pulmonary Arterial Hypertension. Front Med (Lausanne). 2018
1;20(2):209-17. Jul 18;5:204.
7. ‘Aubert R, Venner C, Huttin O, Haine D, Filippetti L, Guillaumot A, et al. Three- 17. Wang Z, Chesler NC. Pulmonary vascular wall stiffness: An important
Dimensional Echocardiography for the Assessment of Right Ventriculo-Arterial contributor to the increased right ventricular afterload with pulmonary
Coupling. J Am Soc Echocardiogr. 2018 Aug;31(8):905-15. hypertension. Pulm Circ. 2011 Apr-Jun;1(2):212-23.
8. Cheitlin MD, Armstrong WF, Aurigemma GP, Belle GA, Bierman FZ, Jack L Davis 18. Guihaire J, Haddad F, Boulate D, Decante B, Denault AY, Wu J, et al. Non-
JL, et al.. ACC/AHA/ASE 2003 Guideline Update for the Clinical Application invasive indices of right ventricular function are markers of ventricular-
of Echocardiography: Summary Article A Report of the American College of arterial coupling rather than ventricular contractility: insights from a
Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/ porcine model of chronic pressure overload. Eur Heart J Cardiovasc
AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application Imaging. 2013 Dec;14(12):1140-9.
of Echocardiography). J Am Coll Cardiol..2003;45(5) doi: 10.1016/S0735-
1097(03)01065-9 19. Prins KW, Weir EK, Archer SL, Markowitz J, Rose L, Pritzker M, et al.
Pulmonary pulse wave transit time is associated with right ventricular-
9. E, M, UC, M, B, D, et al. Relationship between Pulmonary Artery Stiffness and pulmonary artery coupling in pulmonary arterial hypertension. Pulm Circ.
Functional Capacity in Patients with Heart Failure with Reduced Ejection Fraction 2016 Dec;6(4):576-85.
. Korean Circ J. 2017 Nov; 47(6): 929–38.
20. Tello K, Dalmer A, Axmann J, Vanderpool R, Ghofrani HA, Naeije R, et
10. Kubba S, Davila CD, Forfia PR. Methods for Evaluating Right Ventricular Function al Reserve of Right Ventricular-Arterial Coupling in the Setting of Chronic
and Ventricular-Arterial Coupling. Prog Cardiovasc Dis. 2016 Jul-Aug;59(1):42-51. Overload. Circ Heart Fail. 2019 Jan;12(1):e005512.
Arq Bras Cardiol. 2021; 116(4):806-811 810Erratum
April 2021 Issue, vol. 116 (4), págs. 806-811
In Original Article “Increased Pulmonary Arterial Stiffness and Impaired Right Ventricle-Pulmonary Artery Coupling In
PCOS”, with DOI number: https://doi.org/10.36660/abc.20190762, published in the Journal Arquivos Brasileiros de
Cardiologia, 116(4):806-811, on page 806, corrigir o nome do autor Hilmi Sumbul para: Hilmi Erdem Sumbul. B”.
DOI: https://doi.org/10.36660/abc.20210556
Este é um artigo de acesso aberto distribuído sob os termos da licença de atribuição pelo Creative Commons
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